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Altaş ZM, Sezerol MA. Frequency of SARS-COV-2 infection and COVID-19 vaccine uptake and protection among Syrian refugees : COVID-19 Vaccine among Syrian Refugees. BMC Infect Dis 2024; 24:570. [PMID: 38851672 PMCID: PMC11161936 DOI: 10.1186/s12879-024-09460-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024] Open
Abstract
It is aimed to examine the frequency of COVID-19 disease, the rates of COVID-19 vaccination and the vaccine effectiveness (VE) among Syrian refugees. It is a retrospective cohort study. Syrian refugees aged 18 years and above registered to a family health center in Sultanbeyli district in Istanbul were included. Vaccine effectiveness were calculated for both Pfizer BioN-Tech and CoronaVac (Sinovac) vaccines. The data of 2586 Syrian people was evaluated in the study. The median age of the participants was 34.0 years (min:18.0; max: 90.0). Of the participants 58.4% (n = 1510) were female, 41.6% (n = 1076) were male. In our study of the refugees 15.7% had history of COVID-19 infection. Refugees having full vaccination with Biontech and Sinovac have a significantly lower COVID-19 infection rate than those without vaccination (HR = 8.687; p < 0.001). Adjusted VE for Biontech, Sinovac, and both were 89.2% (95.0% CI:83.3-93.1), 81.2% (95.0% CI:48.72-93.1) and 88.5% (95.0% CI:82.7-92.3), respectively. The results of the study highlight the importance of vaccinations against COVID-19 pandemic, since both vaccines were highly protective in refugees.
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Affiliation(s)
- Zeynep Meva Altaş
- Department of Public Health, Ümraniye District Health Directorate, Istanbul, 34764, Türkiye.
| | - Mehmet Akif Sezerol
- Epidemiology Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul, 34815, Türkiye
- Department of Public Health, School of Medicine, Istanbul Medipol University, Istanbul, 34815, Türkiye
- Department of Public Health, Sultanbeyli District Health Directorate, Istanbul, 34935, Türkiye
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2
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Nomah DK, Díaz Y, Bruguera A, Moreno-Fornés S, Aceiton J, Reyes-Urueña J, Llibre JM, Falcó V, Imaz A, Fanjul FJ, Peraire J, Deig E, Domingo P, Inciarte A, Casabona J, Miró JM. Disparities in Coronavirus Disease 2019 Clinical Outcomes and Vaccination Coverage Among Migrants With Human Immunodeficiency Virus in the PISCIS Cohort: A Population-Based Propensity Score-Matched Analysis. Open Forum Infect Dis 2024; 11:ofad693. [PMID: 38221982 PMCID: PMC10785217 DOI: 10.1093/ofid/ofad693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) disproportionately affects migrants and ethnic minorities, including those with human immunodeficiency virus (HIV). Comprehensive studies are needed to understand the impact and risk factors. Methods Using data from the PISCIS cohort of people with HIV (PWH) in Catalonia, Spain, we investigated COVID-19 outcomes and vaccination coverage. Among 10 640 PWH we compared migrants and non-migrants assessing rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, diagnosis, and associated clinical outcomes through propensity score matching and multivariable Cox regression. Results The cohort (mean age, 43 years; 83.5% male) included 57.4% (3053) Latin American migrants. Migrants with HIV (MWH) had fewer SARS-CoV-2 tests (67.8% vs 72.1%, P < .0001) but similar COVID-19 diagnoses (29.2% vs 29.4%, P = .847) compared to Spanish natives. Migrants had lower complete vaccination (78.9% vs 85.1%, P < .0001) and booster doses (63.0% vs 65.5%, P = .027). COVID-19 hospitalizations (8.1% vs 5.1%, P < .0001) and intensive care unit (ICU) admissions (2.9% vs 1.2%, P < .0001) were higher among migrants, with similar hospitalization duration (5.5 vs 4.0 days, P = .098) and mortality (3 [0.2%] vs 6 [0.4%], P = .510). Age ≥40 years, CD4 counts <200 cells/μL, ≥2 comorbidities, and incomplete/nonreception of the SARS-CoV-2 vaccine increased the risk of severe COVID-19 among migrants. Conclusions MWH had lower rates of SARS-CoV-2 testing and vaccination coverage, although the rates of COVID-19 diagnosis were similar between migrants and non-migrants. Rates of COVID-19-associated hospitalizations and ICU admissions were higher among migrants in comparison with non-migrants, with similar hospitalization duration and mortality. These findings can inform policies to address disparities in future pandemic responses for MWH.
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Affiliation(s)
- Daniel K Nomah
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol, Barcelona, Spain
| | - Yesika Díaz
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Barcelona, Spain
| | - Andreu Bruguera
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Barcelona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Sergio Moreno-Fornés
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Barcelona, Spain
| | - Jordi Aceiton
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol, Barcelona, Spain
| | - Juliana Reyes-Urueña
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
| | - Josep M Llibre
- Fight Against Infections Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Vicenç Falcó
- Infectious Disease Division, Hospital Universitari Vall D’Hebron, Barcelona, Spain
| | - Arkaitz Imaz
- HIV and STI Unit, Department of Infectious Diseases, Hospital Universitari de Bellvitge–IDIBELL, L’Hospitalet de Llobregat, Spain
| | | | - Joaquim Peraire
- Hospital Joan XXIII, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Elisabet Deig
- Infectious Diseases Unit, Hospital General de Granollers, Granollers, Spain
| | - Pere Domingo
- Department of Infectious Diseases, HIV Infection Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alexy Inciarte
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Jordi Casabona
- Department de Salut, Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Generalitat de Catalunya, Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública, Barcelona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - José M Miró
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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de Dios B, Pérez-Jacoiste A, Lalueza A, Maestro G, García-Reyne A, Lizasoain M, Lumbreras C. Disparities between Latinx migrants and Spanish natives in COVID-19 outcome in Madrid. Pathog Glob Health 2023; 117:590-595. [PMID: 36775987 PMCID: PMC10392248 DOI: 10.1080/20477724.2023.2174295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Previous studies have suggested an increased susceptibility of COVID-19 among certain populations. We analyzed whether COVID-19 presentation and mortality differ between Latinx migrants and Spanish natives. METHODS AND MATERIALS COVID-19 patients between 35-64 years old admitted between January 26th-May-5th 2020 were reviewed. Demographics, major comorbidities, symptoms, signs and analytical parameters on admission were recorded. Respiratory failure was defined as PaO2/FiO2 ≤ 200 mmHg, noninvasive or invasive mechanical ventilation requirement at any time during hospitalization. A propensity score (PS) adjustment was created between Latinx and Spanish. A multivariable logistic regression model adjusted by the PS was performed to evaluate the effects of different variables on mortality. RESULTS 894 patients: 425 (47.5%) Latinx and 469 (52.5%) Spanish natives were included. Latinx were younger (50 vs 55 years p < 0.001) and had less comorbidities (29.4% vs 55.0% p < 0.001) than Spanish natives. More often they exhibited fever (22.1% vs 9.8% p = 0.018) and had higher inflammatory markers (PCR) (11.3 mg/dl vs 7.7 mg/dl p < 0.001). Mortality seemed lower among Latinx (4.7% vs 8.7%, p = 0.017). No association was found between ethnicity and mortality. Respiratory failure [OR = 23.978 (CI 95% 9.4-60.1) p < 0.001], LDH [OR (per unitary increment) = 1.002; CI95% (1.000-1.004;p = 0.036] and PCR [OR (per unitary increment) = 1.044 (CI95% 1.06-1.08); p = 0.02] were independently associated to mortality. CONCLUSIONS We were unable to identify significant ethnic disparities between Latinx and Spanish natives in terms of COVID-19 mortality. Universal access to the health care system in Spain may have contributed to a better outcome of Latinx patients. Differences previously described might be a consequence of socioeconomic disparities.
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Affiliation(s)
- Begoña de Dios
- Internal Medicine Service, Hospital Universitario “12 de Octubre”, Madrid, Spain
- 1 Doctoral Student Rey Juan Carlos University, Madrid, Spain
| | | | - Antonio Lalueza
- Internal Medicine Service, Hospital Universitario “12 de Octubre”, Madrid, Spain
| | - Guillermo Maestro
- Internal Medicine Service, Hospital Universitario “12 de Octubre”, Madrid, Spain
| | - Ana García-Reyne
- Internal Medicine Service, Hospital Universitario “12 de Octubre”, Madrid, Spain
| | - Manuel Lizasoain
- Internal Medicine Service, Hospital Universitario “12 de Octubre”, Madrid, Spain
| | - Carlos Lumbreras
- Internal Medicine Service, Hospital Universitario “12 de Octubre”, Madrid, Spain
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Chilunga FP, Appelman B, van Vugt M, Kalverda K, Smeele P, van Es J, Wiersinga WJ, Rostila M, Prins M, Stronks K, Norredam M, Agyemang C. Differences in incidence, nature of symptoms, and duration of long COVID among hospitalised migrant and non-migrant patients in the Netherlands: a retrospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 29:100630. [PMID: 37261215 PMCID: PMC10079482 DOI: 10.1016/j.lanepe.2023.100630] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 06/02/2023]
Abstract
Background Comprehensive data on long COVID across ethnic and migrant groups are lacking. We investigated incidence, nature of symptoms, clinical predictors, and duration of long COVID among COVID-19 hospitalised patients in the Netherlands by migration background (Dutch, Turkish, Moroccan, and Surinamese origin, Others). Methods We used COVID-19 admissions and follow up data (January 2021-July 2022) from Amsterdam University Medical Centers. We calculated long COVID incidence proportions per NICE guidelines by migration background and assessed for clinical predictors via robust Poisson regressions. We then examined associations between migration background and long COVID using robust Poisson regressions and adjusted for derived clinical predictors, and other biologically relevant factors. We also assessed long COVID symptom persistence at one-year post-discharge. Findings 1886 patients were included. 483 patients had long COVID (26%, 95% CI 24-28%) at 12 weeks post-discharge. Symptoms like dizziness, joint pain, insomnia, and headache varied by migration background. Clinical predictors of long COVID were female sex, hospital admission duration, intensive care unit admission, and receiving oxygen, or corticosteroid therapy. Long COVID risk was higher among patients with migration background than Dutch origin patients after adjustments for derived clinical predictors, age, smoking, vaccination status, comorbidities and remdesivir treatment. Only 14% of long COVID symptoms persisted at one-year post-discharge. Interpretation There are significant differences in occurrence, nature of symptoms, and duration of long COVID by migration background. Studies assessing the spectrum of functional limitation and access to post-COVID healthcare are needed to help plan for appropriate and accessible healthcare interventions. Funding The Amsterdam UMC COVID-19 biobank is supported by the Amsterdam UMC Corona Research Fund and the Talud Foundation (Stichting Talud). The current analyses were supported by the Novo Nordisk Foundation [NNF21OC0067528].
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Affiliation(s)
- Felix Patience Chilunga
- Department of Public and Occupational Health, Amsterdam Public Health, University of Amsterdam Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Brent Appelman
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity (AII), University of Amsterdam, Amsterdam, The Netherlands
| | - Michele van Vugt
- Division of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Institute for Infection and Immunity (AII), University of Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Kirsten Kalverda
- Department Pulmonary Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick Smeele
- Department Pulmonary Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Josien van Es
- Department Pulmonary Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Willem Joost Wiersinga
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity (AII), University of Amsterdam, Amsterdam, The Netherlands
- Division of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Institute for Infection and Immunity (AII), University of Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Maria Prins
- Division of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Institute for Infection and Immunity (AII), University of Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam Public Health, University of Amsterdam Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Marie Norredam
- Section for Health Services Research, Department of Public Health, Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, University of Copenhagen, Copenhagen, Denmark
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health, University of Amsterdam Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Does the Integration of Migrants in the Host Society Raise COVID-19 Vaccine Acceptance? Evidence From a Nationwide Survey in Japan. J Immigr Minor Health 2023; 25:255-265. [PMID: 36129643 PMCID: PMC9490729 DOI: 10.1007/s10903-022-01402-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/30/2022]
Abstract
Research indicates that integration contributes to maintaining health among migrants, yet little is known about the association between integration and vaccination acceptance. This study aimed to explore COVID-19 vaccine intention and acceptance, and the association between integration and vaccine hesitancy among migrants in Japan. We conducted an internet survey among migrants in Japan from October 5 to October 14, 2021. Among 1,455 participants, 11.6% reported hesitancy toward COVID-19 vaccination. We found that the overall integration and social integration were associated with the vaccination intention. Some commonly identified barriers (e.g., financial difficulties, language) were not related to COVID-19 vaccination acceptance among migrants in Japan. Highly integrated migrants were less likely to report vaccine hesitancy against COVID-19. To promote COVID-19 acceptance among migrants, customized intervention policies should focus on the migrants with a lower level of integration, especially those with little social connection with the locals.
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Irizar P, Pan D, Kapadia D, Bécares L, Sze S, Taylor H, Amele S, Kibuchi E, Divall P, Gray LJ, Nellums LB, Katikireddi SV, Pareek M. Ethnic inequalities in COVID-19 infection, hospitalisation, intensive care admission, and death: a global systematic review and meta-analysis of over 200 million study participants. EClinicalMedicine 2023; 57:101877. [PMID: 36969795 PMCID: PMC9986034 DOI: 10.1016/j.eclinm.2023.101877] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 03/08/2023] Open
Abstract
Background COVID-19 has exacerbated existing ethnic inequalities in health. Little is known about whether inequalities in severe disease and deaths, observed globally among minoritised ethnic groups, relates to greater infection risk, poorer prognosis, or both. We analysed global data on COVID-19 clinical outcomes examining inequalities between people from minoritised ethnic groups compared to the ethnic majority group. Methods Databases (MEDLINE, EMBASE, EMCARE, CINAHL, Cochrane Library) were searched from 1st December 2019 to 3rd October 2022, for studies reporting original clinical data for COVID-19 outcomes disaggregated by ethnicity: infection, hospitalisation, intensive care unit (ICU) admission, and mortality. We assessed inequalities in incidence and prognosis using random-effects meta-analyses, with Grading of Recommendations Assessment, Development, and Evaluation (GRADE) use to assess certainty of findings. Meta-regressions explored the impact of region and time-frame (vaccine roll-out) on heterogeneity. PROSPERO: CRD42021284981. Findings 77 studies comprising over 200,000,000 participants were included. Compared with White majority populations, we observed an increased risk of testing positive for infection for people from Black (adjusted Risk Ratio [aRR]:1.78, 95% CI:1.59-1.99, I2 = 99.1), South Asian (aRR:3.00, 95% CI:1.59-5.66, I2 = 99.1), Mixed (aRR:1.64, 95% CI:1.02-1.67, I2 = 93.2) and Other ethnic groups (aRR:1.36, 95% CI:1.01-1.82, I2 = 85.6). Black, Hispanic, and South Asian people were more likely to be seropositive. Among population-based studies, Black and Hispanic ethnic groups and Indigenous peoples had an increased risk of hospitalisation; Black, Hispanic, South Asian, East Asian and Mixed ethnic groups and Indigenous peoples had an increased risk of ICU admission. Mortality risk was increased for Hispanic, Mixed, and Indigenous groups. Smaller differences were seen for prognosis following infection. Following hospitalisation, South Asian, East Asian, Black and Mixed ethnic groups had an increased risk of ICU admission, and mortality risk was greater in Mixed ethnic groups. Certainty of evidence ranged from very low to moderate. Interpretation Our study suggests that systematic ethnic inequalities in COVID-19 health outcomes exist, with large differences in exposure risk and some differences in prognosis following hospitalisation. Response and recovery interventions must focus on tackling drivers of ethnic inequalities which increase exposure risk and vulnerabilities to severe disease, including structural racism and racial discrimination. Funding ESRC:ES/W000849/1.
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Affiliation(s)
- Patricia Irizar
- School of Social Sciences, University of Manchester, United Kingdom
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
- Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, United Kingdom
- NIHR Leicester Biomedical Research Centre, United Kingdom
| | - Dharmi Kapadia
- School of Social Sciences, University of Manchester, United Kingdom
| | - Laia Bécares
- Department of Global Health and Social Medicine, King's College London, United Kingdom
| | - Shirley Sze
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - Harry Taylor
- School of Social Sciences, University of Manchester, United Kingdom
| | - Sarah Amele
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Eliud Kibuchi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Pip Divall
- University Hospitals of Leicester, Education Centre Library, Glenfield Hospital and Leicester Royal Infirmary, United Kingdom
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Laura B Nellums
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
- NIHR Leicester Biomedical Research Centre, United Kingdom
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Nwaru C, Li H, Bonander C, Santosa A, Franzén S, Rosvall M, Nyberg F. Occupational role and COVID-19 among foreign-born healthcare workers in Sweden: a registry-based study. Eur J Public Health 2023; 33:202-208. [PMID: 36762873 PMCID: PMC10066486 DOI: 10.1093/eurpub/ckad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Many studies report that foreign-born healthcare workers (HCWs) in high-income countries have an elevated risk of COVID-19. However, research has not yet specifically evaluated the distribution of COVID-19 among foreign-born workers in different healthcare work groups. We examined the risk of COVID-19 infection and hospitalization among foreign-born HCWs in different occupational roles in Sweden. METHODS We linked occupational data (2019) of 783 950 employed foreign-born workers (20-65 years) to COVID-19 data registered between 1 January 2020 and 30 September 2021. We used Cox proportional hazards regression to estimate the hazard ratio (HR) with 95% confidence intervals (95% CIs) of COVID-19 infection and hospitalization in eight healthcare occupational groups vs. non-HCWs and assessed whether region of birth modified the association between healthcare occupations and COVID-19. RESULTS All HCWs had a higher risk of COVID-19 outcomes than non-HCWs, but the risk differed by occupational role. Hospital-based assistant nurses had the highest risk (infection: HR 1.78; 95% CI 1.72-1.85; hospitalization: HR 1.79; 95% CI 1.52-2.11); allied HCWs had the lowest risk (infection: HR 1.22; 95% CI 1.10-1.35; hospitalization: HR 0.98; 95% CI 0.59-1.63). The relative hazard of the outcomes varied across foreign-born workers from different regions. For example, the relative risk of COVID-19 infection associated with being a physician compared to a non-HCW was 31% higher for African-born than European-born workers. CONCLUSIONS The risk of COVID-19 among foreign-born HCWs differed by occupational role and immigrant background. Public health efforts that target occupational exposures as well as incorporate culturally responsive measures may help reduce COVID-19 risk among foreign-born HCWs.
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Affiliation(s)
- Chioma Nwaru
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Bonander
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Franzén
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Rosvall
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Social Medicine, Regionhälsan, Region Västra Götaland, Gothenburg, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Mazzalai E, Giannini D, Tosti ME, D’Angelo F, Declich S, Jaljaa A, Caminada S, Turatto F, De Marchi C, Gatta A, Angelozzi A, Marchetti G, Pizzarelli S, Marceca M. Risk of Covid-19 Severe Outcomes and Mortality in Migrants and Ethnic Minorities Compared to the General Population in the European WHO Region: a Systematic Review. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2023; 24:1-31. [PMID: 36647529 PMCID: PMC9833641 DOI: 10.1007/s12134-023-01007-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
The Covid-19 pandemic has had a major impact on migrants and ethnic minorities (MEMs). Socio-economic factors and legal, administrative and language barriers are among the reasons for this increased susceptibility. The aim of the study is to investigate the impact of Covid-19 on MEMs compared to the general population in terms of serious outcomes. We conducted a systematic review collecting studies on the impact of Covid-19 on MEMs compared to the general population in the WHO European Region regarding hospitalisation, intensive care unit (ICU) admission and mortality, published between 01/01/2020 and 19/03/2021. Nine researchers were involved in selection, study quality assessment and data extraction. Of the 82 studies included, 15 of the 16 regarding hospitalisation for Covid-19 reported an increased risk for MEMs compared to the white and/or native population and 22 out of the 28 studies focusing on the ICU admission rates found an increased risk for MEMs. Among the 65 studies on mortality, 43 report a higher risk for MEMs. An increased risk of adverse outcomes was reported for MEMs. Social determinants of health are among the main factors involved in the genesis of health inequalities: a disadvantaged socio-economic status, a framework of structural racism and asymmetric access to healthcare are linked to increased susceptibility to the consequences of Covid-19. These findings underline the need for policymakers to consider the socio-economic barriers when designing prevention plans. Supplementary Information The online version contains supplementary material available at 10.1007/s12134-023-01007-x.
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Affiliation(s)
- Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Elena Tosti
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Franca D’Angelo
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Declich
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Aurora Angelozzi
- Department for Organisational Development, Local Health Unit Roma 1, Rome, Italy
| | - Giulia Marchetti
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Scilla Pizzarelli
- Knowledge Unit, Documentation and Library, Istituto Superiore di Sanità, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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Martínez-Alfonso J, Mesas AE, Jimenez-Olivas N, Cabrera-Majada A, Martínez-Vizcaíno V, Díaz-Olalla JM. Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study. Int J Public Health 2022; 67:1605481. [PMID: 36589473 PMCID: PMC9800286 DOI: 10.3389/ijph.2022.1605481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Objective: To analyze whether social deprivation and economic migrant (EM) status influence the risk of being hospitalized with COVID-19. Methods: This was a retrospective follow-up study including all patients older than 18 years attending the Daroca Health Center in Madrid, Spain, diagnosed with COVID-19 during September 2020. Data on EM status and other sociodemographic, lifestyle and comorbidities that could affect the clinical course of the infection were obtained from electronic medical records. Results: Of the 796 patients positive for COVID-19, 44 (5.53%) were hospitalized. No significant differences were observed between those who were hospitalized and those who were not in the mean of social deprivation index or socioeconomic status, but EM status was associated with the risk of being hospitalized (p = 0.028). Logistic regression models showed that years of age (OR = 1.07; 95% CI: 1.04-1.10), EM status (OR = 5.72; 95% CI: 2.56-12.63) and hypertension (OR = 2.22; 95% CI: 1.01-4.85) were the only predictors of hospitalization. Conclusion: Our data support that EM status, rather than economic deprivation, is the socioeconomic factor associated with the probability of hospital admission for COVID-19 in Madrid, Spain.
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Affiliation(s)
| | - Arthur Eumann Mesas
- Universidad de Castilla-La Mancha, Cuenca, Spain,Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil,*Correspondence: Arthur Eumann Mesas,
| | | | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Cuenca, Spain,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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10
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van Ingen T, Brown KA, Buchan SA, Akingbola S, Daneman N, Warren CM, Smith BT. Neighbourhood-level socio-demographic characteristics and risk of COVID-19 incidence and mortality in Ontario, Canada: A population-based study. PLoS One 2022; 17:e0276507. [PMID: 36264984 PMCID: PMC9584389 DOI: 10.1371/journal.pone.0276507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/07/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES We aimed to estimate associations between COVID-19 incidence and mortality with neighbourhood-level immigration, race, housing, and socio-economic characteristics. METHODS We conducted a population-based study of 28,808 COVID-19 cases in the provincial reportable infectious disease surveillance systems (Public Health Case and Contact Management System) which includes all known COVID-19 infections and deaths from Ontario, Canada reported between January 23, 2020 and July 28, 2020. Residents of congregate settings, Indigenous communities living on reserves or small neighbourhoods with populations <1,000 were excluded. Comparing neighbourhoods in the 90th to the 10th percentiles of socio-demographic characteristics, we estimated the associations between 18 neighbourhood-level measures of immigration, race, housing and socio-economic characteristics and COVID-19 incidence and mortality using Poisson generalized linear mixed models. RESULTS Neighbourhoods with the highest proportion of immigrants (relative risk (RR): 4.0, 95%CI:3.5-4.5) and visible minority residents (RR: 3.3, 95%CI:2.9-3.7) showed the strongest association with COVID-19 incidence in adjusted models. Among individual race groups, COVID-19 incidence was highest among neighbourhoods with the high proportions of Black (RR: 2.4, 95%CI:2.2-2.6), South Asian (RR: 1.9, 95%CI:1.8-2.1), Latin American (RR: 1.8, 95%CI:1.6-2.0) and Middle Eastern (RR: 1.2, 95%CI:1.1-1.3) residents. Neighbourhoods with the highest average household size (RR: 1.9, 95%CI:1.7-2.1), proportion of multigenerational families (RR: 1.8, 95%CI:1.7-2.0) and unsuitably crowded housing (RR: 2.1, 95%CI:2.0-2.3) were associated with COVID-19 incidence. Neighbourhoods with the highest proportion of residents with less than high school education (RR: 1.6, 95%CI:1.4-1.8), low income (RR: 1.4, 95%CI:1.2-1.5) and unaffordable housing (RR: 1.6, 95%CI:1.4-1.8) were associated with COVID-19 incidence. Similar inequities were observed across neighbourhood-level sociodemographic characteristics and COVID-19 mortality. CONCLUSIONS Neighbourhood-level inequities in COVID-19 incidence and mortality were observed in Ontario, with excess burden experienced in neighbourhoods with a higher proportion of immigrants, racialized populations, large households and low socio-economic status.
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Affiliation(s)
| | - Kevin A. Brown
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sarah A. Buchan
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Nick Daneman
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Brendan T. Smith
- Public Health Ontario, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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11
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Rodríguez-Guardado A, Álvarez-Martínez MJ, Flores MD, Sulleiro E, Torrús-Tendero D, Velasco M, Membrillo FJ. Screening for strongyloidiasis in Spain in the context of the SARS-CoV-2 pandemic: Results of a survey on diagnosis and treatment. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022:S2529-993X(22)00174-5. [PMID: 35970704 PMCID: PMC9372776 DOI: 10.1016/j.eimce.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/31/2021] [Accepted: 11/06/2021] [Indexed: 12/15/2022]
Abstract
Introduction The generalization of treatment with dexamethasone or other immunosuppressants in patients with SARS-CoV-2 infection may increase the risk of occurrence of severe forms of strongyloidiasis. A nationwide survey was conducted to better understand the diagnostic and therapeutic situation of strongyloidiasis in SARS-CoV-2 co-infected patients in Spain. Materials and methods A survey was designed and sent to all SEIMC members during February and March 2021. Responses were exported for computer processing to Microsoft Excel 2017 and statistically processed with the free software PSPP. Results 189 responses were received, of which 121 (64%) were selected for further processing. Eighty-four centers (69.5%) had no specific strongyloidiasis screening protocol. Forty-two centers (34.7%) had serological techniques available in their laboratories and the rest were sent to a reference laboratory. Only 22 centers (18%) screened for strongyloidiasis in SARS-CoV-2 infected patients. A total of 227 cases of strongyloidiasis were diagnosed in patients with SARS-CoV-2 infection. In four cases patients developed a massive hyperinfestation syndrome leading to the death of one patient. Conclusion COVID-19 has highlighted the need to unify screening and treatment protocols for imported pathologies such as strongyloidiosis. Efforts to disseminate knowledge are needed to ensure that this potentially fatal disease is adequately treated in patients with the highest risk of complications, such as those with COVID-19.
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12
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Ramos-Rincon JM, Cobos-Palacios L, López-Sampalo A, Ricci M, Rubio-Rivas M, Martos-Pérez F, Lalueza-Blanco A, Moragón-Ledesma S, Fonseca-Aizpuru EM, García-García GM, Beato-Perez JL, Josa-Laorden C, Arnalich-Fernández F, Molinos-Castro S, Torres-Peña JD, Artero A, Vargas-Núñez JA, Mendez-Bailon M, Loureiro-Amigo J, Hernández-Garrido MS, Peris-García J, López-Reboiro ML, Barón-Franco B, Casas-Rojo JM, Gómez-Huelgas R. Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry. J Clin Med 2022; 11:1949. [PMID: 35407557 PMCID: PMC8999367 DOI: 10.3390/jcm11071949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5−58.9) to 57.1 (44.1−67.1) vs. 71.5 (59.5−81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10−0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17−1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26−2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21−1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often.
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Affiliation(s)
| | - Lidia Cobos-Palacios
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Almudena López-Sampalo
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Michele Ricci
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | | | | | - Sergio Moragón-Ledesma
- Internal Medicine Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | | | | | - Jose-Luis Beato-Perez
- Internal Medicine Department, Albacete University Hospital Complex, 02006 Albacete, Spain;
| | | | | | - Sonia Molinos-Castro
- Internal Medicine Department, Santiago de Compostela Clinic Hospital, 15706 Santiago de Compostela, Spain;
| | - José-David Torres-Peña
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain;
- Spain CIBER Fisiopatologia de la Obesidad y la Nutricion, Carlos III Health Institute, 28029 Madrid, Spain
| | - Arturo Artero
- Internal Medicine Department, Doctor Peset University Hospital, 46017 Valencia, Spain;
| | - Juan-Antonio Vargas-Núñez
- Internal Medicine Department, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro—Segovia de Arana, 28222 Madrid, Spain;
| | | | - Jose Loureiro-Amigo
- Internal Medicine Department, Moisès Broggi Hospital, 08970 Sant Joan Despí, Spain;
| | | | - Jorge Peris-García
- Internal Medicine Department, de Sant Joan d’Alacant University Clínic Hospital, 03550 Alicante, Spain;
| | | | - Bosco Barón-Franco
- Internal Medicine Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - Jose-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, 28981 Madrid, Spain;
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
- Spain CIBER Fisiopatologia de la Obesidad y la Nutricion, Carlos III Health Institute, 28029 Madrid, Spain
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Morante-García W, Zapata-Boluda RM, García-González J, Campuzano-Cuadrado P, Calvillo C, Alarcón-Rodríguez R. Influence of Social Determinants of Health on COVID-19 Infection in Socially Vulnerable Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031294. [PMID: 35162317 PMCID: PMC8834846 DOI: 10.3390/ijerph19031294] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/18/2022]
Abstract
The coronavirus 2019 (COVID-19) pandemic has had a significant impact on the economy and health, especially for the most vulnerable social groups. The social determinants of health are one of the most relevant risks for becoming infected with COVID-19, due to the health consequences for those who are exposed to it. The objective of this study was to analyze the influence of social determinants in health on COVID-19 infection in vulnerable social groups. A transversal epidemiological study was carried out on 746 individuals in vulnerable situations living in conditions of extreme poverty in disadvantaged areas in the province of Almeria (southeast of Spain). Social determinants of health such access to drinking water (p < 0.001) and economic income (p = 0.04) influenced the infection of COVID-19. A binary logistic regression model showed that the significant predictors of COVID-19 infection were the lack of economic income and inaccessible drinking water. The government and social health services must be aware of this problem in order to play an active role in searching for solutions and implementing public health prevention measures to eliminate social inequalities in health.
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Affiliation(s)
| | - Rosa María Zapata-Boluda
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
| | - Jessica García-González
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
- Correspondence:
| | | | - Cristobal Calvillo
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
| | - Raquel Alarcón-Rodríguez
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
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Jaljaa A, Caminada S, Tosti ME, D'Angelo F, Angelozzi A, Isonne C, Marchetti G, Mazzalai E, Giannini D, Turatto F, De Marchi C, Gatta A, Declich S, Pizzarelli S, Geraci S, Baglio G, Marceca M. Risk of SARS-CoV-2 infection in migrants and ethnic minorities compared with the general population in the European WHO region during the first year of the pandemic: a systematic review. BMC Public Health 2022; 22:143. [PMID: 35057781 PMCID: PMC8771174 DOI: 10.1186/s12889-021-12466-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Migrants and ethnic minorities have suffered a disproportionate impact of the COVID-19 pandemic compared to the general population from different perspectives. Our aim was to assess specifically their risk of infection in the 53 countries belonging to the World Health Organization European Region, during the first year of the pandemic. METHODS We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42021247326). We searched multiple databases for peer-reviewed literature, published on Medline, Embase, Scisearch, Biosis and Esbiobase in 2020 and preprints from PubMed up to 29/03/2021. We included cross-sectional, case-control, cohort, intervention, case-series, prevalence or ecological studies, reporting the risk of SARS-CoV-2 infection among migrants, refugees, and ethnic minorities. RESULTS Among the 1905 records screened, 25 met our inclusion criteria and were included in the final analysis. We found that migrants and ethnic minorities during the first wave of the pandemic were at increased exposure and risk of infection and were disproportionately represented among COVID-19 cases. However, the impact of COVID-19 on minorities does not seem homogeneous, since some ethnic groups seem to be more at risk than others. Risk factors include high-risk occupations, overcrowded accommodations, geographic distribution, social deprivation, barriers to access to information concerning preventive measures (due to the language barrier or to their marginality), together with biological and genetic susceptibilities. CONCLUSIONS Although mixed methods studies will be required to fully understand the complex interplay between the various biological, social, and cultural factors underlying these findings, the impact of structural determinants of health is evident. Our findings corroborate the need to collect migration and ethnicity-disaggregated data and contribute to advocacy for inclusive policies and programmatic actions tailored to reach migrants and ethnic minorities.
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Affiliation(s)
- Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Elena Tosti
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Franca D'Angelo
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Aurora Angelozzi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Claudia Isonne
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Giulia Marchetti
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Silvia Declich
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Scilla Pizzarelli
- National Health Institute; Knowledge Service, Documentation and Library, Rome, Italy
| | - Salvatore Geraci
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- Caritas of Rome, Health Area, Rome, Italy
| | - Giovanni Baglio
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- AGENAS, Research and International Relations Office, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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15
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Nwaru CA, Santosa A, Franzén S, Nyberg F. Occupation and COVID-19 diagnosis, hospitalisation and ICU admission among foreign-born and Swedish-born employees: a register-based study. J Epidemiol Community Health 2022; 76:jech-2021-218278. [PMID: 34996808 PMCID: PMC8761595 DOI: 10.1136/jech-2021-218278] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research on occupation and risk of COVID-19 among foreign-born workers is lacking. We investigated whether working in essential occupations was associated with COVID-19 diagnosis, hospitalisation and intensive care unit (ICU) admission and whether foreign-born workers in similar occupations as Swedish-born individuals had a higher risk of the studied outcomes. METHODS Occupational data (2018-2019) of 326 052 employees (20-65 years) who were resident in Sweden as of 1 January 2020 were linked to COVID-19 data registered from 1 January 2020 to 28 February 2021. We analysed the risk of COVID-19 outcomes in different occupational groups and in four immigrant/occupation intersectional groups using Cox proportional hazards regression with adjustments for sociodemographic and socioeconomic characteristics and pre-existing comorbidities. RESULTS We identified 29797, 1069 and 152 cases of COVID-19 diagnosis, hospitalisations and ICU admissions, respectively, in our cohort. Workers in essential occupations had an elevated risk of COVID-19 diagnosis, hospitalisation, and ICU admissions. Healthcare workers had a higher risk of all the outcomes compared with other essential workers. Relative to Swedish-born workers in non-essential occupations, foreign-born workers in essential occupations had 1.85 (95% CI 1.78 to 1.93), 3.80 (95% CI 3.17 to 4.55) and 3.79 (95% CI 2.33 to 6.14) times higher risk of COVID-19 diagnosis, hospitalisation and ICU admission, respectively. The corresponding risks among Swedish-born workers in essential occupations were 1.44 (95% CI 1.40 to 1.49), 1.30 (95% CI 1.08 to 1.56) and 1.46 (95% CI 0.90 to 2.38). CONCLUSION Occupation was associated with COVID-19 outcomes and contributed to the burden of COVID-19 among foreign-born individuals in this study.
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Affiliation(s)
- Chioma Adanma Nwaru
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Franzén
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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van Ingen T, Brown KA, Buchan SA, Akingbola S, Daneman N, Warren CM, Smith BT. Neighbourhood-level socio-demographic characteristics and risk of COVID-19 incidence and mortality in Ontario, Canada: A population-based study. PLoS One 2022; 17:e0276507. [PMID: 36264984 DOI: 10.1101/2021.01.27.21250618] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/07/2022] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVES We aimed to estimate associations between COVID-19 incidence and mortality with neighbourhood-level immigration, race, housing, and socio-economic characteristics. METHODS We conducted a population-based study of 28,808 COVID-19 cases in the provincial reportable infectious disease surveillance systems (Public Health Case and Contact Management System) which includes all known COVID-19 infections and deaths from Ontario, Canada reported between January 23, 2020 and July 28, 2020. Residents of congregate settings, Indigenous communities living on reserves or small neighbourhoods with populations <1,000 were excluded. Comparing neighbourhoods in the 90th to the 10th percentiles of socio-demographic characteristics, we estimated the associations between 18 neighbourhood-level measures of immigration, race, housing and socio-economic characteristics and COVID-19 incidence and mortality using Poisson generalized linear mixed models. RESULTS Neighbourhoods with the highest proportion of immigrants (relative risk (RR): 4.0, 95%CI:3.5-4.5) and visible minority residents (RR: 3.3, 95%CI:2.9-3.7) showed the strongest association with COVID-19 incidence in adjusted models. Among individual race groups, COVID-19 incidence was highest among neighbourhoods with the high proportions of Black (RR: 2.4, 95%CI:2.2-2.6), South Asian (RR: 1.9, 95%CI:1.8-2.1), Latin American (RR: 1.8, 95%CI:1.6-2.0) and Middle Eastern (RR: 1.2, 95%CI:1.1-1.3) residents. Neighbourhoods with the highest average household size (RR: 1.9, 95%CI:1.7-2.1), proportion of multigenerational families (RR: 1.8, 95%CI:1.7-2.0) and unsuitably crowded housing (RR: 2.1, 95%CI:2.0-2.3) were associated with COVID-19 incidence. Neighbourhoods with the highest proportion of residents with less than high school education (RR: 1.6, 95%CI:1.4-1.8), low income (RR: 1.4, 95%CI:1.2-1.5) and unaffordable housing (RR: 1.6, 95%CI:1.4-1.8) were associated with COVID-19 incidence. Similar inequities were observed across neighbourhood-level sociodemographic characteristics and COVID-19 mortality. CONCLUSIONS Neighbourhood-level inequities in COVID-19 incidence and mortality were observed in Ontario, with excess burden experienced in neighbourhoods with a higher proportion of immigrants, racialized populations, large households and low socio-economic status.
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Affiliation(s)
| | - Kevin A Brown
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sarah A Buchan
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Nick Daneman
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Brendan T Smith
- Public Health Ontario, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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[Screening for strongyloidiasis in Spain in the context of the SARS-CoV-2 pandemic: results of a survey on diagnosis and treatment]. Enferm Infecc Microbiol Clin 2021:S0213-005X(21)00386-4. [PMID: 34931102 PMCID: PMC8673747 DOI: 10.1016/j.eimc.2021.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/06/2021] [Indexed: 12/15/2022]
Abstract
Introducción La generalización del tratamiento con dexametasona u otros inmunosupresores en pacientes con infección por SARS-CoV-2 puede aumentar el riesgo de aparición de formas graves de estrongiloidiosis. Se realizó una encuesta a nivel nacional para conocer mejor de la situación diagnóstica y terapéutica de la estrongiloidiosis en España en pacientes coinfectados por SARS-CoV-2. Materiales y métodos Se diseñó una encuesta que fue enviada a todos los miembros de SEIMC durante los meses de febrero y marzo de 2021. Las respuestas se exportaron para su procesamiento informático al programa Microsoft Excel 2017 y se procesaron estadísticamente con el software libre PSPP. Resultados Se recibieron 189 respuestas, de las cuales se seleccionaron 121 (64%) para su procesamiento posterior. En 84 centros (69,5%) no existía ningún protocolo de cribado específico de estrongiloidiosis. Cuarenta y dos centros (34,7%) disponían de técnicas serológicas en sus laboratorios y en el resto se enviaban a un laboratorio de referencia. Solo 22 centros (18%) realizaron cribado de estrongiloidiosis en pacientes infectados por SARS-CoV-2. Se diagnosticaron 227 casos de estrongiloidiosis en pacientes con infección por el SARS-CoV-2. En cuatro casos los pacientes desarrollaron un síndrome de hiperinfestación masiva que condujo al fallecimiento de uno. Conclusión La COVID-19 ha puesto de manifiesto la necesidad de unificar protocolos de cribado y tratamiento de patologías importadas como la estrongiloidiosis. Es necesario realizar un esfuerzo de difusión del conocimiento para que esta patología potencialmente mortal sea tratada adecuadamente en los pacientes con mayor riesgo de complicaciones, como son aquellos con COVID-19.
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Sempere A, Salvador F, Monforte A, Sampol J, Espinosa-Pereiro J, Miarons M, Bosch-Nicolau P, Guillén-del-Castillo A, Aznar ML, Campos-Varela I, Sánchez-Montalvá A, Leguízamo-Martínez LM, Oliveira I, Antón A, Almirante B. COVID-19 Clinical Profile in Latin American Migrants Living in Spain: Does the Geographical Origin Matter? J Clin Med 2021; 10:5213. [PMID: 34830495 PMCID: PMC8622310 DOI: 10.3390/jcm10225213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to describe and compare the clinical characteristics of hospitalized patients with COVID-19 pneumonia according to their geographical origin. This is a retrospective case-control study of hospitalized patients with confirmed COVID-19 pneumonia treated at Vall d'Hebron University Hospital (Barcelona) during the first wave of the pandemic. Cases were defined as patients born in Latin America and controls were randomly selected among Spanish patients matched by age and gender. Demographic and clinical variables were collected, including comorbidities, symptoms, vital signs and analytical parameters, intensive care unit admission and outcome at 28 days after admission. Overall, 1080 hospitalized patients were registered: 774 (71.6%) from Spain, 142 (13.1%) from Latin America and the rest from other countries. Patients from Latin America were considered as cases and 558 Spanish patients were randomly selected as controls. Latin American patients had a higher proportion of anosmia, rhinorrhea and odynophagia, as well as higher mean levels of platelets and lower mean levels of ferritin than Spanish patients. No differences were found in oxygen requirement and mortality at 28 days after admission, but there was a higher proportion of ICU admissions (28.2% vs. 20.2%, p = 0.0310). An increased proportion of ICU admissions were found in patients from Latin America compared with native Spanish patients when adjusted by age and gender, with no significant differences in in-hospital mortality.
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Affiliation(s)
- Abiu Sempere
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Arnau Monforte
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Júlia Sampol
- Department of Pneumology, Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Juan Espinosa-Pereiro
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Marta Miarons
- Department of Pharmacy, Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | | | - Maria Luisa Aznar
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Isabel Campos-Varela
- Liver Unit, Vall d’Hebron Hospital Universitari, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Lina María Leguízamo-Martínez
- Department of Pharmacovigilance and Pharmacoepidemiology, Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Inés Oliveira
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
| | - Andrés Antón
- Department of Microbiology, Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Benito Almirante
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (A.S.); (A.M.); (J.E.-P.); (P.B.-N.); (M.L.A.); (A.S.-M.); (I.O.); (B.A.)
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Varela AR, Florez LJH, Tamayo-Cabeza G, Contreras-Arrieta S, Restrepo SR, Laajaj R, Gutierrez GB, Guevara YPR, Caballero-Díaz Y, Florez MV, Osorio E, Barbieri IS, Sanchez DR, Nuñez LL, Bernal R, Oliveros SR, Zapata LS, Guevara-Suarez M, Uribe AG, Behrentz E. Factors Associated With SARS-CoV-2 Infection in Bogotá, Colombia: Results From a Large Epidemiological Surveillance Study. LANCET REGIONAL HEALTH. AMERICAS 2021; 2:100048. [PMID: 34458886 PMCID: PMC8382233 DOI: 10.1016/j.lana.2021.100048] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Epidemiologic surveillance of COVID-19 is essential to collect and analyse data to improve public health decision making during the pandemic. There are few initiatives led by public-private alliances in Colombia and Latin America. The CoVIDA project contributed with RT-PCR tests for SARS-CoV-2 in mild or asymptomatic populations in Bogotá. The present study aimed to determine the factors associated with SARS-CoV-2 infection in working adults. METHODS COVID-19 intensified sentinel epidemiological surveillance study, from April 18, 2020, to March 29, 2021. The study included people aged 18 years or older without a history of COVID-19. Two main occupational groups were included: healthcare and essential services workers with high mobility in the city. Social, demographic, and health-related factors were collected via phone survey. Afterwards, the molecular test was conducted to detect SARS-CoV-2 infection. FINDINGS From the 58,638 participants included in the study, 3,310 (5·6%) had a positive result. A positive result was associated with the age group (18-29 years) compared with participants aged 60 or older, participants living with more than three cohabitants, living with a confirmed case, having no affiliation to the health system compared to those with social health security, reporting a very low socioeconomic status compared to those with higher socioeconomic status, and having essential occupations compared to healthcare workers. INTERPRETATION The CoVIDA study showed the importance of intensified epidemiological surveillance to identify groups with increased risk of infection. These groups should be prioritised in the screening, contact tracing, and vaccination strategies to mitigate the pandemic. FUNDING The CoVIDA study was funded through donors managed by the philanthropy department of Universidad de los Andes.
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Affiliation(s)
| | | | | | | | | | - Rachid Laajaj
- Department of Economics, Universidad de los Andes, Bogotá, Colombia
| | | | | | | | - Martha Vives Florez
- Department of Biological Sciences, Universidad de los Andes, Bogotá, Colombia
| | - Elkin Osorio
- Secretaría Distrital de Salud de Bogotá D.C, Colombia
| | | | | | | | - Raquel Bernal
- Department of Economics, Universidad de los Andes, Bogotá, Colombia
| | | | | | - Marcela Guevara-Suarez
- Applied genomics research group, Vicerrectoría de Investigación y Creación, Universidad de los Andes, Bogotá, Colombia
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20
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Otero-Rodriguez S, Moreno-Pérez O, Ramos JM, García M, Boix V, Reus S, Torrus D, Chico-Sánchez P, Sánchez-Payá J, Aldana-Macias F, Gil J, Portilla J, Merino E. Latin American Origin Is Not Associated with Worse Outcomes among Hospitalized Patients with COVID-19 in a Public Healthcare System. Microorganisms 2021; 9:1772. [PMID: 34442851 PMCID: PMC8398476 DOI: 10.3390/microorganisms9081772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/22/2022] Open
Abstract
Exploring differences in clinical outcomes based on race and origin among patients hospitalized for COVID-19 is a controversial issue. The ALC COVID-19 Registry includes all confirmed COVID-19 patients admitted to hospital from 3 March 2020 to 17 December 2020. The data were obtained from electronic health records in order to evaluate the differences in the clinical features and outcomes among European and Latin American patients. The follow-ups occurred after 156 days. A propensity score weighting (PSW) logistic regression model was used to estimate the odds ratio (OR, 95% CI) for Latin American origin and outcome associations. Of the 696 patients included, 46.7% were women, with a median age of 65 (IQR 53-67) years, 614 (88.2%) were European, and 82 (11.8%) were Latin American. Latin American patients were younger, with fewer comorbidities, and a higher incidence of extensive pneumonia. After adjusting for residual confounders, Latin American origin was not associated with an increased risk of death (PSW OR 0.85 (0.23-3.14)) or with the need for invasive mechanical ventilation (PSW OR 0.35 (0.12-1.03)). Latin American origin was associated with a shorter hospital stay, but without differences in how long the patient remained on mechanical ventilation. In a public healthcare system, the rates of death or mechanical ventilation in severe COVID-19 cases were found to be comparable between patients of European and Latin American origins.
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Affiliation(s)
- Silvia Otero-Rodriguez
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Unit of Infectious Diseases, Alicante General University Hospital, 03010 Alicante, Spain
| | - Oscar Moreno-Pérez
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Endocrinology and Nutrition Department, Alicante General University Hospital, 03013 Alicante, Spain
- Clinical Medicine Department, Miguel Hernández University, 03202 Elche, Spain
| | - Jose Manuel Ramos
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Clinical Medicine Department, Miguel Hernández University, 03202 Elche, Spain
- Internal Medicine Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - Mar García
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Internal Medicine Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - Vicente Boix
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Unit of Infectious Diseases, Alicante General University Hospital, 03010 Alicante, Spain
- Clinical Medicine Department, Miguel Hernández University, 03202 Elche, Spain
| | - Sergio Reus
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Unit of Infectious Diseases, Alicante General University Hospital, 03010 Alicante, Spain
- Clinical Medicine Department, Miguel Hernández University, 03202 Elche, Spain
| | - Diego Torrus
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Unit of Infectious Diseases, Alicante General University Hospital, 03010 Alicante, Spain
- Parasitology Area, Miguel Hernández University, 03202 Elche, Spain
| | - Pablo Chico-Sánchez
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Preventive Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - José Sánchez-Payá
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Preventive Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - Fernando Aldana-Macias
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Pneumology Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - Joan Gil
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Pneumology Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - Joaquín Portilla
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Clinical Medicine Department, Miguel Hernández University, 03202 Elche, Spain
- Internal Medicine Department, Alicante General University Hospital, 03010 Alicante, Spain
| | - Esperanza Merino
- Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (S.O.-R.); (O.M.-P.); (J.M.R.); (M.G.); (V.B.); (S.R.); (D.T.); (P.C.-S.); (J.S.-P.); (F.A.-M.); (J.G.); (J.P.)
- Unit of Infectious Diseases, Alicante General University Hospital, 03010 Alicante, Spain
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Sánchez-Cantalejo C, Rueda MDM, Saez M, Enrique I, Ferri R, Fuente MDL, Villegas R, Castro L, Barceló MA, Daponte-Codina A, Lorusso N, Cabrera-León A. Impact of COVID-19 on the Health of the General and More Vulnerable Population and Its Determinants: Health Care and Social Survey-ESSOC, Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8120. [PMID: 34360413 PMCID: PMC8345631 DOI: 10.3390/ijerph18158120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/16/2021] [Accepted: 07/27/2021] [Indexed: 12/22/2022]
Abstract
This manuscript describes the rationale and protocol of a real-world data (RWD) study entitled Health Care and Social Survey (ESSOC, Encuesta Sanitaria y Social). The study's objective is to determine the magnitude, characteristics, and evolution of the COVID-19 impact on overall health as well as the socioeconomic, psychosocial, behavioural, occupational, environmental, and clinical determinants of both the general and more vulnerable population. The study integrates observational data collected through a survey using a probabilistic, overlapping panel design, and data from clinical, epidemiological, demographic, and environmental registries. The data will be analysed using advanced statistical, sampling, and machine learning techniques. The study is based on several measurements obtained from three random samples of the Andalusian (Spain) population: general population aged 16 years and over, residents in disadvantaged areas, and people over the age of 55. Given the current characteristics of this pandemic and its future repercussions, this project will generate relevant information on a regular basis, commencing from the beginning of the State of Alarm. It will also establish institutional alliances of great social value, explore and apply powerful and novel methodologies, and produce large, integrated, high-quality and open-access databases. The information described here will be vital for health systems in order to design tailor-made interventions aimed at improving the health care, health, and quality of life of the populations most affected by the COVID-19 pandemic.
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Affiliation(s)
- Carmen Sánchez-Cantalejo
- Andalusian School of Public Health (EASP, Escuela Andaluza de Salud Pública), 18080 Granada, Spain; (C.S.-C.); (A.D.-C.)
- Institute of Biosanitary Research, ibs.Granada. (IBS-E-10), 18080 Granada, Spain
| | - María del Mar Rueda
- Department of Statistics and Operations Research, University of Granada, 18014 Granada, Spain; (M.d.M.R.); (R.F.); (L.C.)
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain; (M.S.); (M.A.B.)
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Iria Enrique
- Andalusian Institute of Statistics and Cartography, 41071 Seville, Spain;
| | - Ramón Ferri
- Department of Statistics and Operations Research, University of Granada, 18014 Granada, Spain; (M.d.M.R.); (R.F.); (L.C.)
| | | | | | - Luis Castro
- Department of Statistics and Operations Research, University of Granada, 18014 Granada, Spain; (M.d.M.R.); (R.F.); (L.C.)
| | - Maria Antònia Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain; (M.S.); (M.A.B.)
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Antonio Daponte-Codina
- Andalusian School of Public Health (EASP, Escuela Andaluza de Salud Pública), 18080 Granada, Spain; (C.S.-C.); (A.D.-C.)
- Institute of Biosanitary Research, ibs.Granada. (IBS-E-10), 18080 Granada, Spain
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Andalusian Health and Environment Observatory (OSMAN), Andalusian School of Public Health (EASP), 18080 Granada, Spain
| | - Nicola Lorusso
- Health Surveillance Service, Department of Health and Families, Andalusian Regional Government, 41020 Seville, Spain;
| | - Andrés Cabrera-León
- Andalusian School of Public Health (EASP, Escuela Andaluza de Salud Pública), 18080 Granada, Spain; (C.S.-C.); (A.D.-C.)
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Cross-sectional study of SARS-CoV2 clinical characteristics in an immigrant population attended in a Hospital Emergency Department in the Catalunya Health Region in Spain. J Migr Health 2021; 4:100055. [PMID: 34151311 PMCID: PMC8204845 DOI: 10.1016/j.jmh.2021.100055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/02/2021] [Accepted: 06/13/2021] [Indexed: 11/24/2022] Open
Abstract
Aim The COVID pandemic has been the biggest health challenge faced in decades. The aim of this study is to assess the characteristics of immigrant patients who attended a Hospital Emergency Department during the first three waves of the coronavirus pandemic. Methods A retrospective, descriptive study of immigrant patients treated in a Hospital Emergency Department between March 15 and November 30, 2020. A descriptive analysis and a comparative analysis were carried out according to place of origin, gender and age. For the comparative analysis, the chi-square test for qualitative variables was used. For the comparative analysis according to gender, Student's t test or the Mann-Whitney U test was used for normal or non-normal quantitative variables, respectively. The Kruskal-Wallis test was used for normal or non-normal quantitative variables according to age. Results We have analyzed 633 immigrant patients who visited the emergency department during the study period. Of the sample, 50.1% patients were women and 78% of all patients came from Africa. The mean age of the patients was 44.1 years. Most patients (72.5%) were discharged to home after evaluation in the emergency department, especially European patients. One-quarter of patients required social resources to be able to comply with quarantine measures, of whom 87% were African. Forty-seven percent of patients became infected at home and 41% in the workplace. Conclusions The immigrant population is generally younger and less infected than the population at large. In addition, the use of social resources to guarantee patient isolation has often proved essential in controlling outbreaks that have arisen in these communities.
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23
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Jeremijenko A, Chemaitelly H, Ayoub HH, Alishaq M, Abou-Samra AB, Al Ajmi JAAA, Al Ansari NAA, Al Kanaani Z, Al Khal A, Al Kuwari E, Al-Mohammed A, Al Molawi NHA, Al Naomi HM, Butt AA, Coyle P, El Kahlout RA, Gillani I, Kaleeckal AH, Masoodi NA, Thomas AG, Nafady-Hego H, Latif AN, Shaik RM, Younes NBM, Rahim HFA, Yassine HM, Al Kuwari MG, Al Romaihi HE, Al-Thani MH, Bertollini R, Abu-Raddad LJ. Herd Immunity against Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 10 Communities, Qatar. Emerg Infect Dis 2021; 27:1343-1352. [PMID: 33900174 PMCID: PMC8084480 DOI: 10.3201/eid2705.204365] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We investigated what proportion of the population acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and whether the herd immunity threshold has been reached in 10 communities in Qatar. The study included 4,970 participants during June 21-September 9, 2020. Antibodies against SARS-CoV-2 were detected by using an electrochemiluminescence immunoassay. Seropositivity ranged from 54.9% (95% CI 50.2%-59.4%) to 83.8% (95% CI 79.1%-87.7%) across communities and showed a pooled mean of 66.1% (95% CI 61.5%-70.6%). A range of other epidemiologic measures indicated that active infection is rare, with limited if any sustainable infection transmission for clusters to occur. Only 5 infections were ever severe and 1 was critical in these young communities; infection severity rate of 0.2% (95% CI 0.1%-0.4%). Specific communities in Qatar have or nearly reached herd immunity for SARS-CoV-2 infection: 65%-70% of the population has been infected.
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